Fluid-assisted medical devices, systems and methods

Abstract

Surgical devices for treating tissue are provided. Also provided are systems for treating tissue and methods of treating tissue. An exemplary surgical device has a handle, a fluid passage connectable to a fluid source, a tip portion and a distal end. The tip portion can simultaneously provide RF power and conductive fluid to tissue. The tip portion includes an electrode having a domed portion having a domed surface and a cylindrical portion having a cylindrical surface. The domed portion is located distal to the cylindrical portion and occupies at least a portion of the distal end of the surgical device. The device includes a fluid outlet opening in fluid communication with the fluid passage, the fluid outlet opening configured to provide the conductive fluid to a surface of the electrode proximal to the distal end surface of the surgical device.

We claim: 
     
       1. A surgical method for treating tissue comprising:
 providing tissue having a tissue surface; 
 providing radio frequency power and an electrically conductive fluid to an electrosurgical device having a tip portion which simultaneously provides the radio frequency power and the electrically conductive fluid to a tissue treatment site, the tip portion comprising at least one fluid outlet opening and a non-porous blunt distal end provided by an exposed electrode; 
 providing an electrically conductive fluid from the electrosurgical device at a fluid flow rate; 
 forming a localized fluid coupling with the electrically conductive fluid which couples the tissue surface and the electrode, the fluid coupling localized at the tip portion of the electrosurgical device; 
 providing the radiofrequency power to the tissue; 
 moving the tip portion of the electrosurgical device along the tissue; 
 coagulating the tissue with the electrosurgical device without cutting the tissue; and 
 blunt dissecting the tissue with the tip portion of electrosurgical device after coagulating the tissue. 
 
     
     
       2. The method according to  claim 1  wherein:
 the tissue comprises parenchymal tissue. 
 
     
     
       3. The method according to  claim 1  wherein:
 the tissue comprises collagen. 
 
     
     
       4. The method according to  claim 1  wherein:
 the tissue comprises organ tissue. 
 
     
     
       5. The method according to  claim 1  wherein:
 the electrically conductive fluid comprises saline solution. 
 
     
     
       6. The method according to  claim 1  wherein:
 the exposed electrode comprises a domed portion. 
 
     
     
       7. The method according to  claim 6  wherein:
 the at least one fluid outlet opening is located proximal to the domed portion of the exposed electrode. 
 
     
     
       8. The method according to  claim 6  wherein:
 the exposed electrode further comprises a cylindrical portion proximal to the domed portion. 
 
     
     
       9. The method according to  claim 8  wherein:
 the at least one fluid outlet opening is arranged to provide fluid to the cylindrical portion of the exposed electrode. 
 
     
     
       10. The method according to  claim 1  wherein:
 the at least one fluid outlet opening is at least partially defined by the exposed electrode. 
 
     
     
       11. The method according to  claim 1  further comprising:
 a fluid passage in fluid communication with the at least one fluid outlet opening. 
 
     
     
       12. A surgical method comprising:
 providing tissue; 
 providing an electrically conductive fluid and radiofrequency power to an electrosurgical device having a tip portion to treat the tissue, the tip portion comprising a sintered metal electrode; 
 placing the electrode on the tissue; 
 providing the electrically conductive fluid and the radiofrequency power simultaneously from the device to treat the tissue; and 
 blunt dissecting the tissue with the electrosurgical device. 
 
     
     
       13. The method of  claim 12  wherein:
 blunt dissecting the tissue is performed during a resection procedure. 
 
     
     
       14. The method of  claim 13  wherein:
 the resection procedure is to remove a portion of tissue, the portion of tissue removed comprising a tumor. 
 
     
     
       15. The method of  claim 12  further comprising:
 forming a localized fluid coupling with the electrically conductive fluid which couples the tissue and the electrode, 
 the fluid coupling localized at the tip portion of the device. 
 
     
     
       16. The method of  claim 12  further comprising:
 moving the electrode along the tissue. 
 
     
     
       17. The method of  claim 12  further comprising:
 moving the electrode along a line of resection. 
 
     
     
       18. The method of  claim 12  further comprising:
 treating the tissue along a line of resection. 
 
     
     
       19. The method of  claim 12  further comprising:
 treating the tissue within a crevice. 
 
     
     
       20. The method of  claim 12  further comprising:
 treating the tissue sufficiently to provide coagulation. 
 
     
     
       21. The method of  claim 20  wherein:
 blunt dissecting the tissue is performed at the same time as coagulation. 
 
     
     
       22. The method of  claim 20  wherein:
 blunt dissecting the tissue is performed after coagulation. 
 
     
     
       23. The method of  claim 12  wherein:
 the tissue comprises a blood vessel. 
 
     
     
       24. The method of  claim 23  further comprising:
 identifying the blood vessel in the tissue from blunt dissecting. 
 
     
     
       25. The method of  claim 24  further comprising:
 treating the tissue sufficiently to shrink the blood vessel. 
 
     
     
       26. The method of  claim 12  wherein:
 the tissue comprises collagen. 
 
     
     
       27. The method of  claim 26  further comprising:
 treating the tissue sufficiently to shrink the collagen. 
 
     
     
       28. The method of  claim 12  further comprising:
 removing a portion of tissue, the portion of tissue removed comprising a tumor. 
 
     
     
       29. The method of  claim 12  wherein:
 the tissue comprises organ tissue. 
 
     
     
       30. The method of  claim 12  wherein:
 the tissue comprises parenchymal tissue. 
 
     
     
       31. The method of  claim 12  wherein:
 the tissue comprises liver tissue. 
 
     
     
       32. The method of  claim 12  wherein:
 the tissue comprises at least one of lung, pancreas and kidney tissue. 
 
     
     
       33. The method of  claim 12  wherein:
 the electrically conductive fluid comprises saline. 
 
     
     
       34. The method of  claim 32  wherein:
 the saline is normal saline. 
 
     
     
       35. The method of  claim 12  wherein:
 the electrically conductive fluid comprises an electrolyte solution. 
 
     
     
       36. The method of  claim 32  wherein:
 the electrically conductive fluid is provided from a fluid source, the fluid source comprising a bag of saline. 
 
     
     
       37. The method of  claim 12  wherein:
 the electrosurgical device comprises:
 a handle; 
 a rigid shaft extending distally beyond the handle, the shaft having a distal end; 
 the electrode extends distally beyond the distal end of the shaft, 
 a fluid delivery lumen; and 
 the electrode in fluid communication with the fluid delivery lumen. 
 
 
     
     
       38. The method of  claim 12  wherein:
 the sintered metal electrode is porous. 
 
     
     
       39. The method of  claim 38  wherein:
 the porous sintered metal electrode comprises a plurality of pores. 
 
     
     
       40. The method of  claim 39  wherein:
 the pores have a pore size in a range of 2.5 micrometers to 500 micrometers. 
 
     
     
       41. The method of  claim 39  wherein:
 the pores have a pore size in a range of 10 micrometers to 120 micrometers. 
 
     
     
       42. The method of  claim 39  wherein:
 the pores have a pore size and a range of 20 micrometers to 80 micrometers. 
 
     
     
       43. The method of  claim 12  wherein:
 the sintered metal electrode is pervious to the passage of the fluid. 
 
     
     
       44. The method of  claim 12  wherein:
 the sintered metal electrode at least partially defines a fluid outlet. 
 
     
     
       45. The method of  claim 12  wherein:
 the electrosurgical device has fluid flow adjustment mechanism. 
 
     
     
       46. The method of  claim 12  wherein:
 the electrosurgical device has a switch to activate the radiofrequency power. 
 
     
     
       47. The method of  claim 12  wherein:
 the electrosurgical device is a monopolar device. 
 
     
     
       48. The method of  claim 12  wherein:
 the electrosurgical device is a laparoscopic surgery device. 
 
     
     
       49. The method of  claim 12  wherein:
 the electrosurgical device is an open surgery device. 
 
     
     
       50. A surgical method comprising:
 providing tissue; 
 providing an electrically conductive fluid and radiofrequency power to an electrosurgical device having a tip portion to treat the tissue, the tip portion comprising a metal electrode wherein the metal electrode comprises a porous structure and bonded metal particles; 
 placing the electrode on the tissue; 
 providing the electrically conductive fluid in the radiofrequency power simultaneously from the device to treat the tissue; 
 blunt dissecting the tissue with the electrosurgical device.